title: Women veterans' healthcare delivery preferences and use by military service era: findings from the National Survey of Women Veterans.
abstract: BACKGROUND
  The number of women Veterans (WVs) utilizing the Veterans Health Administration (VA) has doubled over the past decade, heightening the importance of understanding their healthcare delivery preferences and utilization patterns. Other studies have identified healthcare issues and behaviors of WVs in specific military service eras (e.g., Vietnam), but delivery preferences and utilization have not been examined within and across eras on a population basis.
  
  
  OBJECTIVE
  To identify healthcare delivery preferences and healthcare use of WVs by military service era to inform program design and patient-centeredness.
  
  
  METHODS
  Cross-sectional 2008-2009 survey of a nationally representative sample of 3,611 WVs, weighted to the population.
  
  
  METHODS
  Healthcare delivery preferences measured as importance of selected healthcare features; types of healthcare services and number of visits used; use of VA or non-VA; all by military service era.
  
  
  RESULTS
  Military service era differences were present in types of healthcare used, with World War II and Korea era WVs using more specialty care, and Vietnam era-to-present WVs using more women's health and mental health care. Operations Enduring Freedom, Iraqi Freedom, New Dawn (OEF/OIF/OND) WVs made more healthcare visits than WVs of earlier military eras. The greatest healthcare delivery concerns were location convenience for Vietnam and earlier WVs, and cost for Gulf War 1 and OEF/OIF/OND WVs. Co-located gynecology with general healthcare was also rated important by a sizable proportion of WVs from all military service eras.
  
  
  CONCLUSIONS
  Our findings point to the importance of ensuring access to specialty services closer to home for WVs, which may require technology-supported care. Younger WVs' higher mental health care use reinforces the need for integration and coordination of primary care, reproductive health and mental health care.
authors.affiliation: VA Greater Los Angeles Health Services Research and Development (HSR&D) Center of Excellence for the Study of Healthcare Provider Behavior, Sepulveda, CA USA. Donna.washington@va.gov
authors.forename: Donna L
authors.initials: DL
authors.lastname: Washington
authors.forename: Bevanne
authors.initials: B
authors.lastname: Bean-Mayberry
authors.forename: Alison B
authors.initials: AB
authors.lastname: Hamilton
authors.forename: Kristina M
authors.initials: KM
authors.lastname: Cordasco
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Yano
mesh_terms: D000293:Adolescent; D000328:Adult; D055826:Afghan Campaign 2001-; D000368:Aged; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D054542:Iraq War, 2003-2011; D047869:Korean War; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology; D057240:Patient Preference / Q000523:psychology*; D011159:Population Surveillance / Q000379:methods; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology; D058014:Veterans Health; D047829:Vietnam Conflict; D047789:World War II; D055815:Young Adult